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There seems to be evidence to suggest that long term psychiatric conditions have effects on grey matter in the brain and the development of certain sections of the brain.

Do antipsychotics have a protective effect on the brain against the degenerative effects of schizophrenia relapse?

I have found many academic papers both supporting and contradicting a protective effect, but finding an agreed upon consensus is difficult. I'm also looking for evidence indicating what effect a schizophrenic relapse has on the brain and the exact degenerative effects that occur.

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After my edit, this appears to be a duplicate of your other question: cogsci.stackexchange.com/questions/6090/… –  what Apr 2 at 10:31
    
@what Thanks for the edit. The two questions are very much linked you are correct but they are different questions. One is asking what the effect of antipsychotic medication is on the brain and the other is asking what effect the illness has on the brain. Personally I consider them separate questions but if you'd rather see them merged I'd understand. –  Cromulent Apr 2 at 10:33

1 Answer 1

This seems like a multi-part question to me, but I'll try to focus specifically on "Being a person who enjoys knowing the facts behind any claims made can anyone provide clinical proof to what my psychiatrist is saying?"

The short answer is "No."

  • Publication bias. As you have discovered, evidence regarding schizophrenia is often contradictory and almost always controversial. Focusing on systematic reviews and meta-analyses might help narrow your research, but even these studies have been challenged when it comes to schizophrenia. One sytematic review found that the change in ventricular brain volume increased as the size of the research team decreased, suggesting significant publication bias on the topic.

  • The heterogeneity problem. Many psychiatrists and cognitive scientists have argued that we will never have any "facts" about schizophrenia because it does not exist as the traditional diagnostic entity that doctors are taught about it school. I'd say that most evidence about schizophrenia suggests that it is more like a set of symptoms that are frequently grouped together as a syndrome rather than a well-defined disease entity. In other words, a random group of 10 individuals diagnosed with schizophrenia might suffer from superficially or clinically related, but morphologically and etiologically distinct illnesses. In fact, the NIMH has said that it will no longer fund new research on top-down broad diagnostic constructs like schizophrenia, instead favoring the more bottom-up "Research Domain Criteria". My favorite writer on this topic is GE Berrios. Search scholar.google.com for "Schizophrenia: A conceptual History." More popular writers include Bentall (e.g., "Madness Explained", also free access through google scholar) and Pat Bracken (and more generally the fields of "postpsychiatry" and "critical psychiatry").

  • Paradigmatic differences between research teams from different cultures and disciplines. Keep in mind that your psychiatrist is a psychiatrist, and has been educated in a strong biomedical model, especially if he is in the United States. In contrast, the British Psychological Society's Division of Clinical Psychology published a formal position statement arguing against the disease model (search for "Position Statement on the Classification of Behaviour and Experience in Relation to Functional Psychiatric Diagnoses: Time for a Paradigm Shift"). If you want a second opinion, try seeing a psychologist or social worker from the UK.

Sorry for not posting more links. StackOverflow says that I need at least 10 reputation points to post more than 2 links.

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I feel like this must be really dangerous territory. If you interpret this as a plain answer it may make sense, but already biased toward stopping to use medication it will be merely confirming that same bias. Unless you feel that based on this short text you would wish to support a withdrawal from medication by this user and other users who feel the same way, I would specify the answer. The fact that Schizophrenia may be a collection of sicknesses says nothing about quitting prescribed medication that may be targeting part of it. The psychologist definitely has more information. –  Spork Mar 28 at 16:18
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I don't think the poster was asking about whether or not s/he should stop taking medications. S/he asked if anyone could provide clinical "proof" about something. Maybe I should delete the part about making one's own decision? I thought it was worth adding the information about the harm reduction guide even though it didn't seem relevant to the question, because this definitely is potentially dangerous territory (especially depending on what medication s/he was taking) and it seems like this user had already decided to quit taking medication anyway. –  user4628 Mar 28 at 17:57

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